Only 7% of Namibians can afford private medical aid

Out of Namibia’s population of three million only 219 790 people, or approximately 7%, can afford to pay for private medical aid, excluding government employees.

The N$5-billion medical aid fund industry comprises eight medical aid funds according to a report on the Namibia Financial Institutions Supervisory Authority (Namfisa) website.

These funds include Namibia Health Plan, Namibia Medical Care, Nammed Medical Aid Fund, Napotel Medical Aid Fund, Renaissance Health Namibia, Gem Health, Heritage Health Namibia and Bankmed Namibia.

Currently, the medical aid fund industry has assets to the value of N$2.8 billion with total investments standing at N$2.3 billion.

According to Namfisa, the industry’s current liabilities increased by 18.1% in the last three months, to N$729.6 million.

“This was primarily due to higher accounts payable, incurred but not reported claims provisions and rollover benefits.

However, the industry’s investments were sufficient to settle these liabilities,” reads the report.

Contributions from medical aid fund members decreased by 0.3% to N$1.5 billion for the quarter ended 31 December 2024.

However, on a yearly basis, contributions increased by 11.4%.

“The quarterly decline in contributions received was due to new younger members who contribute at lower rates – though this has little impact on the average age of the beneficiaries – and some members downgrading to cheaper options,” reads the report.

The average contribution income per beneficiary was N$6 913, while the average claims per beneficiary was N$5 272.

The industry is also facing risk from a larger number of pensioner beneficiaries when compared to younger members taking up medical aid.

“The sustained annual increase in pensioner members in the absence of enrolment of sufficient new younger members is expected to present higher claim risks for the industry, as older members generally claim more than younger members,” reads the report.

The report says enrolling younger and healthier beneficiaries at a higher rate than pensioner beneficiaries would be advantageous to the industry, as it would contribute to long-term sustainability.

The industry’s healthcare claims decreased to N$1.2 billion.

According to the report, the decrease in claims was due to a combination of members’ claims behaviour and seasonality of claims.

“Claims fluctuate during the four quarters of the year, peak during the second and third quarters and reduce during the fourth quarter. This is due to members having run out of benefits, and lower incidences of illness during the fourth quarter,” reads the report.

Namfisa reports that 69.9% of the total health expenditure was attributed to hospital admissions, medicines dispensed by pharmacists and visits to general practitioners and specialists.

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